GS Paper IV — Q4
(a) Citing the serious adverse effects of long-term medication, a doctor convinces the family of a female patient for surgery…
Citing the serious adverse effects of long-term medication, a doctor convinces the family of a female patient for surgery. This led the patient to reluctantly consent for the surgery, though her original choice was to opt for medication. Explain the concepts of paternalism and beneficence by analysing the doctor's action. (Answer in 150 words) 10 marks
Efficiency is doing things right, while effectiveness is doing the right thing. How do you strike a balance between the two to enhance productivity? (Answer in 150 words) 10 marks
हिंदी में प्रश्न पढ़ें
लंबे समय तक दवा लेने के गंभीर दुष्प्रभावों का हवाला देते हुए, एक डॉक्टर एक महिला मरीज के परिवार को सर्जरी के लिए राजी कर लेता है। इससे मरीज अनिच्छा से सर्जरी के लिए सहमत हो जाती है, जबकि उसकी मूल इच्छा दवा लेने की थी। डॉक्टर के इस कार्य का विश्लेषण करके पितृसत्तावाद और परोपकारिता की अवधारणाओं को स्पष्ट कीजिए। (उत्तर 150 शब्दों में दीजिए)
दक्षता का अर्थ है कार्यों को सही ढंग से करना, जबकि प्रभावशीलता का अर्थ है सही कार्य करना। उत्पादकता बढ़ाने के लिए आप इन दोनों के बीच संतुलन कैसे स्थापित करते हैं? (उत्तर 150 शब्दों में दीजिए)
Model answer
Drafted with AI by UPSC Answer Check against this question's marking rubric, to the 150-word length. UPSC does not publish answers for Mains — this is one way to score well, not an official key. How we build rubrics and answers.
(a) Paternalism is overriding a person’s expressed preference to promote their welfare; beneficence is acting in the patient’s best interest. The doctor’s action was paternalistic: he overrode her preference by invoking serious adverse effects to persuade the family; her “reluctant” consent was mediated by family pressure, not fully voluntary or informed. Persuading the family instead of the woman herself also sidelines her as the decision-maker; the Supreme Court in Samira Kohli v. Prabha Manchanda (2008) held that an adult patient's own consent is required. Thus, while beneficence justifies the doctor in advising strongly and disclosing risks, it conflicts with autonomy when the patient’s original choice for medication is displaced. Soft paternalism, intervening only to ensure her choice is informed and voluntary, would be defensible; hard paternalism, displacing her informed choice through family pressure, is not.
(b) Efficiency means doing things right—optimal resource use; effectiveness means doing the right thing—achieving validated goals (Drucker). Balance requires outcome-based KPIs tied to public objectives, periodic goal-relevance review, and process redesign to avoid the activity trap where efficient routines serve outdated ends. For instance, counting toilets built measures efficiency, whereas their use and sustained ODF status measure effectiveness; outcome budgeting and third-party evaluation keep both in view. Prioritisation (e.g., the Eisenhower matrix), delegation, and technology such as DBT cut waste without losing sight of goals. Efficiency alone risks doing the wrong thing well; effectiveness alone risks waste. Productivity rises when means align with validated ends.
How this answer will be evaluated
Framework: GS4 Ethical Dilemma & Management Principles
What earns full marks: Precise definitions, clear application to the case, and actionable, well-structured measures.
Evaluation rubric
Each sub-part is marked on its own, against the marks and word limit printed on the paper.
- (a) Explain paternalism and beneficence by analysing the doctor's action of persuading the family into surgery against the patient's original choice. 10 marks · 150 words
explain— definition/context → points in order → small example → short close
Must cover
- Define medical paternalism (doctor decides for patient)
- Define beneficence (acting in patient's best interest)
- Identify violation of patient autonomy in the scenario
- Analyze the conflict between doctor's intent and patient's choice
Loses marks
- Defining terms without applying them to the case
- Ignoring the patient's original choice for medication
- Preaching general ethics without analyzing the specific action
Earns more
- Mention informed consent as a key ethical principle
- Reference the 'do no harm' principle
- Distinguish between 'soft' and 'hard' paternalism
- Mention the role of the family in the decision
Extra mark
- Cite Samira Kohli v. Prabha Manchanda (2008) or Common Cause (2018) on the adult patient's own consent and self-determination
- Note the gender dimension: the family, not the woman herself, was persuaded
- (b) Explain how to strike a balance between efficiency and effectiveness to enhance productivity. 10 marks · 150 words
suggest— the problem in one line → implementable measures → who acts → conclusion
Must cover
- Define efficiency (doing things right) and effectiveness (doing the right things)
- Show why one without the other fails (wrong goals done well vs. right goals done wastefully)
- Propose measures for balance: outcome indicators, feedback/evaluation, prioritisation
- Link the balance to enhanced productivity with an example
Loses marks
- Treating efficiency and effectiveness as mutually exclusive
- Providing only theoretical definitions without practical application
- Ignoring the 'productivity' aspect of the question
Earns more
- Mention the 'Pareto Principle' (80/20 rule)
- Suggest setting SMART goals
- Discuss the role of time management
- Mention the importance of strategic planning
Extra mark
- Cite a specific management framework like 'Balanced Scorecard'
- Reference a specific productivity tool or methodology
What "Explain" is asking you to do
Make the working of something clear — what sets it off, what follows from what, and what it produces. Explain is the Commission's mechanism word: it dominates the technical papers and the “explain why” stems, where the marks sit in the causal chain and not in the label.
Structure that answers it
State what it is → the initiating condition → the chain of cause, step by step → an instance where it plays out → what the chain produces
Where marks are lost
Describing what something looks like instead of why it works that way. Naming the stages without linking them reads as description too.
Practice this exact question
Write your answer and it is marked point by point against the model answer above — what you covered, what you missed, what you got wrong.
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